中国普通外科杂志2011，Vol.20Issue(7)：673-675,3.
完全腹腔镜下原发性肝癌切除32例报告
Experience in total-laparoscopic hepatectomy for primary liver cancer:a report of 32 cases
周乐杜 1龚学军 1李劲东 1王志明1
作者信息
- 1. 中南大学湘雅医院普通外科,湖南长沙410008
- 折叠
摘要
Abstract
Objective To study the safety, feasibility and minimal invasiveness of laparoscopic hepatectomy for primary liver cancer. Methods The clinical data of 32 patients with primary liver cancer undergoing laparoscopic hepatectomy from October 2008 to February 2011 were retrospectively analyzed. Results Laparoscopic hepatectomies were successfully performed in all patients without convertion to an open surgery. The lesions were located in Couinaud hepatic segment II (n = 3 ) , segment III ( n = 8) , segments II and III ( n = 10) , segment IV ( n = 2 ) , segment V ( n = 4 ) and segment VI ( n = 5 ) , respectively. All patients had a single lesion combined with liver cirrhosis and the lesion size ranged from 1.8 to 9. 2 cm. The grades of liver function before operation was Child' s grade A ( n = 27 ) and Child' s grade B ( n = 5 ) , respectively. The operative procedures consisted of left hemihepatectomy ( n = 2 ) , left lateral lobectomy ( n = 15) and local resection ( n = 15), respectively. The liver parenchyma was transected by combining Laparoscopic ultrosonic scalpel with LigaSure or Endo-GIA. Two patients underwent hepatic inflow occlusion for 15 and 22 min, respectively, and 3 patients received 2 units of RBC transfusion. No postoperative complications such as bleeding, biliary leakage or liver failure occurred. All cases recovered and discharged. Three cases had local tumor relapse and no death occurred in the 32 patients during the follow-up period of 5-26 months. Conclusions Laparoscopic hepatectomy for primary liver cancer is safe and feasible. Indications of laparoscopic hepatectomy for primary liver cancer should be strictly defined because the procedure has high technical difficulty. The size and location of the hepatic lesions are the major selective indicators. The combination of ultrosonic scalpel and LigaSure for liver transection has the advantages of good hemostatic effect and clear anatomy.关键词
肝肿瘤/外科学/肝切除术/方法/腹腔镜/原发性肝癌Key words
Liver Neoplasms/surg/ Hepatectomy/ methods/Laparoscopy/ Primary Liver Cancer分类
医药卫生引用本文复制引用
周乐杜,龚学军,李劲东,王志明..完全腹腔镜下原发性肝癌切除32例报告[J].中国普通外科杂志,2011,20(7):673-675,3.
